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Active NPI 1801687355 Individual Practitioner Female Practitioner

Mia Mckenzie Walters , PA-C

Physician Assistant • Glen Carbon, IL

Professional Overview & Biography Verified Profile Summary

Mia Walters, PA-C is a certified Physician Assistant practicing in Glen Carbon, IL. With approximately 1 years of clinical experience since completing medical education in 2025, Mia Walters delivers high-quality medical care to the local community at 1455 VILLAGE CIRCLE DR.

Mia Walters does not directly accept Medicare assignment.

Practice Location & Contact Primary Location

Practice Address

1455 Village Circle Dr

Glen Carbon, IL 620344321

Telephone 6184771810
Associated Practice Facility / Clinic
🏢 Bellevue Radiology Inc Facility NPI 1083689228

Medicare Profile & Education

Medical School

Other

Graduation Year

2025

Medicare Assignment

Not Specified

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Glen Carbon, IL

Rising Specialist (<5 Yrs)
Practitioner Clinical Experience
1 Yrs -7.3 yrs vs City Avg
City Avg: 8.3 Yrs
State Avg: 11.7 Yrs
Regional Practice Density
3 Specialists

Practicing in Glen Carbon, IL (4958 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Walters (1 Years) 1 Yrs
Glen Carbon Specialty Average (8.3 Years) 8.3 Yrs

Medical Specialties & State Licenses

CMS Verified: 2025-11-24
Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License MO 2025038815

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events
📍
Updated Business Mailing Address November 24, 2025

Registered at 6420 CLAYTON RD, SAINT LOUIS, MO 631171811 (Tel: 3147688360)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) November 24, 2025

Physician Assistant (License #2025038815 in MO)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 19, 2025

Physician Assistant

NPI Profile Active May 14, 2025

NPI status registered as active in NPPES database

📍
Updated Practice Location May 14, 2025

Registered at 1455 VILLAGE CIRCLE DR, GLEN CARBON, IL 620344321 (Tel: 6184771810)

📍
Updated Business Mailing Address May 14, 2025

Registered at 1455 VILLAGE CIRCLE DR, GLEN CARBON, IL 620344321 (Tel: 6184771810)

👤
Provider Name / Credentials Updated May 14, 2025

Recorded as MIA WALTERS, PA-C

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) May 14, 2025

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration May 14, 2025

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1801687355
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 14, 2025
Last Update: November 24, 2025
Sole Proprietor: Yes

Mailing Address

6420 Clayton Rd

Saint Louis, MO 631171811

Phone: 3147688360

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.